Image of the Month: Multifocal 68Ga Prostate-Specific Membrane Antigen Ligand Uptake in the Skeleton in a Man With Both Prostate Cancer and Multiple Myeloma

Ga prostate-specific membrane antigen (PSMA) HBED-CC PET/CT in a 65-year-old man with first diagnosis of prostate cancer (PC) and a history of multiple myeloma showing multifocal PSMA ligand uptake in the skeleton with corresponding osteolytic lesions in CT. Although osteolytic bone metastases are very rare in PC, PSMA expression in PET raised the suspicion of PC bone metastases. Bone marrow biopsy excluded PC metastases with immunohistochemistry showing endothelial expression of PSMA in small vessels within the myeloma.